How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $891.25 Median $2,290.87 Typical High $7,585.78 | Facility | None | $891.25 | $2,290.87 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $229.09 Typical High $331.13 | Professional | None | $141.25 | $229.09 | $331.13 |
BCBS Tennessee Setting Facility Modifier None Typical Low $524.81 Median $1,122.02 Typical High $2,570.40 | Facility | None | $524.81 | $1,122.02 | $2,570.40 |
BCBS Tennessee Setting Professional Modifier None Typical Low $181.97 Median $316.23 Typical High $602.56 | Professional | None | $181.97 | $316.23 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $208.93 Median $389.05 Typical High $1,659.59 | Facility | None | $208.93 | $389.05 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $234.42 Typical High $389.05 | Professional | None | $144.54 | $234.42 | $389.05 |
Lucent Health Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $2,238.72 | Professional | None | $1,819.70 | $1,819.70 | $2,238.72 |
United Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $2,511.89 | Facility | None | $346.74 | $1,047.13 | $2,511.89 |
United Setting Professional Modifier None Typical Low $147.91 Median $239.88 Typical High $446.68 | Professional | None | $147.91 | $239.88 | $446.68 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $70.79 Median $114.82 Typical High $165.96 | Professional | 52 · Reduced service | $70.79 | $114.82 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $45.71 Typical High $66.07 | Professional | 53 · Discontinued | $28.18 | $45.71 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $169.82 Typical High $245.47 | Professional | 54 · Surgery only | $104.71 | $169.82 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $34.67 Typical High $48.98 | Professional | 55 · Aftercare only | $21.38 | $34.67 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $22.91 Typical High $33.11 | Professional | 56 · Pre-op care only | $14.13 | $22.91 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $158.49 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $97.72 | $158.49 | $229.09 |
Where Tennessee sits
The same service costs 3.5 times more in Alaska than in Kentucky. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Tennessee· 12th of 51
$309
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.